Devices, Apparatuses, Kits, and Methods for Repair of Articular Surface and/or Articular Rim

ABSTRACT

Embodiments of devices, apparatuses, kits, and methods for repairing and/or augmenting the articular surface and/or articular rim of a joint (e.g., repairing the anterior glenoid rim after an anterior shoulder dislocation).

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application No.61/665,092, filed Jun. 27, 2012, which is incorporated by reference inits entirety.

BACKGROUND

1. Field of the Invention

The present invention relates generally to orthopedic treatments, andmore particularly, but not by way of limitation, to devices,apparatuses, kits, and methods for repairing and/or augmenting thearticular surface and/or articular rim of a joint.

2. Description of Related Art

One example of a method for repairing (e.g., after a fracture resultingfrom an anterior shoulder dislocation) the rim of a patient's glenoid(glenoid fossa) is known as the Laterjet procedure, in which a portionof a patient's coracoid process is removed and attached to the claviclein a position where a portion of the glenoid rim has previously brokenoff, to augment the anterior glenoid and stabilize the humeral head inthe shoulder joint. Fitting the removed portion of the coracoid processto the anterior glenoid rim involves a trial-and-error approach thatrequires a surgeon (or other healthcare provider) to iteratively shapethe removed portion of the coracoid process to the anterior glenoid toaugment the glenoid rim without interfering with motion of the joint.This trial-and-error approach may, in some instances, be complicated byvariations in coracoid shape.

SUMMARY

This disclosure includes embodiments of devices, apparatuses, kits, andmethods for repairing and/or augmenting the articular surface and/orarticular rim of a joint.

Some embodiments of the present devices comprise: a pre-formed bodycomprising a coupling side and a concave side disposed at a non-parallelangle relative to the coupling side, the body configured to be coupledto a bone adjacent to a selected type of human joint socket such thatthe coupling side faces the bone and the concave side augments thearticular surface of the joint. In some embodiments, the body isconfigured to be coupled to a scapula adjacent the glenoid such that theconcave side augments an anterior portion of the glenoid rim. In someembodiments, the body comprises one or more holes extending through thebody without extending through the concave side such that the body canbe coupled to the bone by one or more screws extending through the oneor more holes. In some embodiments, the one or more holes each has acentral longitudinal axis that is not perpendicular to the couplingside. In some embodiments, the body comprises a plurality of projectionsextending outwardly from the coupling side and configured to resistmovement of the body relative to the bone. In some embodiments, the bodycomprises a non-biological material. In some embodiments, the materialcomprises steel. In some embodiments, the coupling side is configured topermit bone ingrowth into the body. In some embodiments, at least aportion of the coupling side is at least one of porous and etched. Insome embodiments, the body comprises a structural material and a coatingmaterial. In some embodiments, the coating material covers substantiallyall of the concave side but does not cover substantially all of thecoupling side. In some embodiments, the structural material comprisesone or more pores or passages. In some embodiments, the concave side issubstantially smooth. In some embodiments, the body further includes anouter side that cooperates with the concave side to form an outer rim,and the coupling side and concave side cooperate to form an inner rim.In some embodiments, the inner rim is concave and the outer rim isconvex.

Some embodiments of the present apparatuses comprise: a jig having abody with a first side and a second side, the first side configured tobe disposed in contact with an articular surface of a selected type ofhuman joint socket, the body having one or more holes each extendingthrough the first side and the second side such that if the first sideis disposed in contact with an articular surface of the selected type ofhuman joint socket, the longitudinal axis of the hole will extend intobone adjacent the joint socket without passing through the articularsurface. In some embodiments, the first side is configured to bedisposed in contact with a glenoid such that the central longitudinalaxis of each of the one or more holes extends through the scapulaadjacent the glenoid. In some embodiments, at least a portion of thefirst side is convex.

Some embodiments of the present apparatuses further comprise: a pinhaving a first end, a second end, and a depth indicator, the pinconfigured to be inserted into the bone adjacent the selected type ofhuman joint socket through one of the one or more holes in the body ofthe jig to a depth indicated by the depth indicator such that the secondend extends a predetermined distance out of the bone. In someembodiments, the depth indicator comprises a mark on the pincorresponding to a portion of the second side of the body of the jig.

Some embodiments of the present apparatuses further comprise: a reamerconfigured to be disposed over the second end of one of the pin when thefirst end of the pin is disposed in the bone, and rotated to remove aportion of the bone to form a mating surface on the bone. In someembodiments, the reamer comprises a cutting end, a distal end, and anelongated passage extending from the cutting end toward the distal end,the passage configured to receive at least a portion of one of the oneor more pins. In some embodiments, the reamer comprises a shoulder inthe passage, the shoulder configured to contact the second end of thepin to limit the depth to which the cutting end can cut. In someembodiments, the shape of the mating surface corresponds to the shape ofthe coupling side of the body of one of the present devices. In someembodiments, the mating surface and the coupling side are eachsubstantially planar.

Some embodiments of the present kits comprise: one or more of thepresent devices; and one or more of the present apparatuses. In someembodiments, the device(s) and apparatus(es) are sterile. In someembodiments, the device(s) and apparatus(es) are disposed in a sealedpackage.

Some embodiments of the present methods (e.g., of repairing a humanjoint socket) comprise: coupling a device having a pre-formed body to abone adjacent to a human joint socket, where the body comprises acoupling side and a concave side disposed at a non-parallel anglerelative to the coupling side, and the body is coupled to the bone suchthat the coupling side faces the bone and the concave side augments thearticular surface of the joint socket. Some embodiments furthercomprise: shaping, prior to coupling the body to the bone, the bone tocorrespond to the shape of the coupling side. In some embodiments,shaping comprises: disposing a jig of one of the present apparatusessuch that the first side contacts the articular surface of the jointsocket; inserting a pin of one the present apparatuses into the bonethrough one of the one or more holes of the body of the jig to a depthindicated by the depth indicator; removing the jig while the pin isdisposed in the bone; disposing a reamer of one of the presentapparatuses over the second end of the pin and rotating the reamer toshape the bone; and removing the reamer and the pin. In someembodiments, the one or more holes in the body of the jig comprises twoholes, and shaping further comprises: inserting a pin of one of thepresent apparatuses the bone through a second one of the one or moreholes in the body of the jig to a depth indicated by the depthindicator; removing the jig while the second pin is disposed in thebone; disposing a reamer of one of the present apparatuses over thesecond end of the second pin and rotating the reamer to shape the bone;and removing the reamer and the second pin. In some embodiments,coupling comprises inserting one or more screws through the body andinto the bone. In some embodiments, the preformed body comprises thepre-formed body of one of the present devices. In some embodiments, thejoint socket comprises the glenoid, and where the body is coupled to thebone in which a portion of the glenoid rim is missing.

Any embodiment of any of the present devices, apparatuses, kits, andmethods can consist of or consist essentially of—rather thancomprise/include/contain/have—any of the described steps, elements,and/or features. Thus, in any of the claims, the term “consisting of” or“consisting essentially of” can be substituted for any of the open-endedlinking verbs recited above, in order to change the scope of a givenclaim from what it would otherwise be using the open-ended linking verb.

Details associated with the embodiments described above and others arepresented below.

BRIEF DESCRIPTION OF THE DRAWINGS

The following drawings illustrate by way of example and not limitation.For the sake of brevity and clarity, every feature of a given structureis not always labeled in every figure in which that structure appears.Identical reference numbers do not necessarily indicate an identicalstructure. Rather, the same reference number may be used to indicate asimilar feature or a feature with similar functionality, as maynon-identical reference numbers. The figures are drawn to scale (unlessotherwise noted), meaning the sizes of the depicted elements areaccurate relative to each other for at least the embodiments depicted inthe figures.

FIGS. 1A-1D depict various views of an embodiment of the present devicesfor repairing and/or augmenting the articular surface and/or articularrim of a joint socket.

FIG. 2 depicts a perspective view of embodiments of a jig and a pin ofthe present apparatuses for preparing a bone to be coupled to the deviceof FIGS. 1A-1D.

FIG. 3A depicts a perspective view of a normal human glenoid.

FIGS. 3B-3G depict various views of stages of the present methods ofrepairing an anterior glenoid rim fracture with the device of FIGS.1A-1D, using the apparatus of FIG. 2.

FIG. 4 depicts a perspective view of a human scapula with a device ofFIGS. 1A-1D coupled to the anterior glenoid.

DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

The term “coupled” is defined as connected, although not necessarilydirectly, and not necessarily mechanically; two items that are “coupled”may be unitary with each other. The terms “a” and “an” are defined asone or more unless this disclosure explicitly requires otherwise. Theterm “substantially” is defined as largely but not necessarily whollywhat is specified (and includes what is specified; e.g., substantially90 degrees includes 90 degrees and substantially parallel includesparallel), as understood by a person of ordinary skill in the art. Inany embodiment of the present devices, apparatuses, kits, and methods,the term “substantially” may be substituted with “within [a percentage]of” what is specified, where the percentage includes 0.1, 1, 5, and/or10 percent.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, anapparatus or kit that “comprises,” “has,” “includes” or “contains” oneor more elements possesses those one or more elements, but is notlimited to possessing only those elements. Likewise, a method that“comprises,” “has,” “includes” or “contains” one or more steps possessesthose one or more steps, but is not limited to possessing only those oneor more steps.

Further, an apparatus, device, or structure that is configured in acertain way is configured in at least that way, but it can also beconfigured in other ways than those specifically described.

Referring now to the drawings, and more particularly to FIGS. 1A-1D,shown therein and designed by the reference numeral 10 is one embodimentof the present devices for repairing and/or augmenting the articularsurface of a joint socket (e.g., by restoring the articular curvatureand/or the articular rim). In the embodiment shown, device 10 comprisesa pre-formed body 14 comprising a coupling side 18 and a concave side22. In this embodiment, concave side 22 is disposed at a non-parallelangle 26 relative to coupling side 18. For example, in the embodimentshown, angle 26 is between 30 degrees and 60 degrees (e.g., between 40and 50 degrees). In other embodiments, angle 26 can be less than 30degrees or more than 60 degrees, to enable body 14 to function withvarious types of joints. In the embodiment shown, body 14 is configuredto be coupled to a bone adjacent to a selected type of human jointsocket such that the coupling side faces the bone and the concave sideaugments the articular surface of the joint. For example, in theembodiment shown, body 10 is configured to repair an anterior fractureof a patient's glenoid rim, such as may be caused by anterior shoulderdislocation(s). More particularly, body 14 is configured to be coupledto a human scapula adjacent the glenoid (e.g., an anterior portion ofthe glenoid) such that the concave side augments an anterior portion ofthe glenoid rim. Other embodiments can be configured to repair and/oraugment the articular surface and/or articular rim of other joints(e.g., can augment the articular surface of the acetabulum in apatient's hip joint).

In some embodiments, body 14 is configured to be coupled to the bone byone or more screws (e.g., screws 500 of FIG. 4). For example, in theembodiment shown, body 14 comprises one or more (e.g., two, as shown)holes 30 extending through the body without extending through concaveside 22, such that body 14 can be coupled to the bone by one or morescrews extending through the one or more holes. In the embodiment shown,each hole 30 has a central longitudinal axis 34 that is notperpendicular to coupling side 18. In other embodiments, axis 34 may beperpendicular to coupling side 18. In the embodiment shown, holes 30each has an enlarged or countersunk outer portion 34 defining a shoulder38. In this embodiment, portion 34 is enlarged to receive the head of ascrew (e.g., screws 500 of FIG. 4) against shoulder 38 and within theoutermost perimeter of body 14.

In some embodiments, body 14 comprises a plurality of projectionsextending outwardly from coupling side 18 and configured to resistmovement of the body relative to the bone. For example, in theembodiment shown, body 14 comprises a plurality of (e.g., conical)spikes 42 configured to extend into the bone adjacent a joint socketwhen body 14 is coupled to the bone. In other embodiments, projectionshave any suitable other shape that resists lateral movement of body 14relative to bone (e.g., in a direction parallel to coupling side 18). Insome embodiments, coupling side 18 is configured to permit bone ingrowthinto body 14 (e.g., inwardly relative to at least one portion ofcoupling side 18, such that ingrown bone will resist lateral movement ofbody 14 relative to the bone. For example, in the embodiment shown,coupling side 18 comprises a plurality of open channels 46 extendingparallel to coupling side 18. In other embodiments, coupling side 18 cancomprise any suitable features configured to permit bone ingrowth intobody 14. For example, in some embodiments, coupling side 18 can betextured (e.g., at least a portion of the coupling side can be at leastone of porous and etched). In most embodiments, concave side 22 issubstantially smooth (e.g., polished or otherwise devoid of surfaceirregularities that might otherwise interfere with joint motion whenbody is coupled to a bone such that concave surface 22 augments thearticular surface of the joint).

Body 14 can comprise one or more of a variety of non-biologicalmaterials (not harvested from a human patient or other animal). Forexample, body 14 can comprise one or more of stainless steel, titanium,biocompatible polymer, and/or any other material that permits body 14 tofunction as described in this disclosure. In some embodiments, body 14comprises a structural material that defines a plurality of the volumeof body 14, and a coating material disposed around the structuralmaterial that defines at least a portion of the outermost surface ofbody 14. For example, the structural material can comprise one or morepores, passages, or interstices (e.g., can be porous) and besubstantially-rigid and/or biocompatible (e.g., metal foam, polymerlattice, and/or the like), and/or the coating material can comprise asubstantially smooth and hard biocompatible coating (e.g., ceramic,polymer, metallic shell, and/or the like). In such compositeembodiments, coupling side can be configured to permit bone ingrowth byconfiguring the coating material to cover substantially all of concaveside 22 but does not cover substantially all of coupling side 18 (e.g.,coating material does not cover all or part of coupling side, such thatbone ingrowth is permitted into the pores, passages, or interstices ofthe structural material.

In the embodiment shown, body 14 further includes an outer side 50 thatcooperates with concave side 22 to form an outer rim 54 (e.g., a roundor radius between outer side 50 and concave side 22). In thisembodiment, coupling side 18 and concave side 22 also cooperate to forman inner rim 58 (e.g., a round or radius between coupling side 18 andconcave side 22). In the embodiment shown, inner rim 58 is concave, andouter rim 54 is convex. In this embodiment, outer rim 54 is configuredto augment the articular rim of the glenoid of a patient.

Referring now to FIGS. 2-4, shown therein are various components of thepresent apparatuses for use with device 100, and various steps ofexemplary embodiments of the present methods for such use. FIG. 2depicts a perspective view of embodiments of a jig 100 and a pin 200 ofthe present apparatuses for preparing a bone to be coupled to device 10.In the embodiment shown, jig 100 has body 104 with a first side 108configured to be disposed in contact with an articular surface of aselected type human joint socket, and a second side 112. For example, insome embodiments, a portion of first side 108 is convex. For example, inthe embodiment shown, the portion of first side 108 corresponding toprimary portion 120 is convex and contoured to correspond to the shapeof the inferior aspect of the glenoid, such that when in contact withthe articular surface of the glenoid, the convex portion indicates theposition of jig 100 at which pin(s) 200 should be inserted into thebone, as described in more detail below. In the embodiment shown, body104 has one or more (e.g., two, as shown) holes 116 a, 116 b eachextending through first side 108 and second side 112 such that if thefirst side is disposed in contact with an articular surface of theselected type of human joint socket, the longitudinal axis of the holewill extend into bone adjacent the joint socket without passing throughthe articular surface. For example, in the embodiment shown, body 104comprises a circular primary portion 120 and one or more (e.g., two, asshown) projections 124 a, 124 b offset from the center of, primaryportion 120 and extending at an angle 128 to distal ends 132 a, 132 b.In the embodiment shown, angle 128 is between 30 degrees and 60 degrees(e.g., between 40 and 50 degrees). In other embodiments, angle 128 canbe less than 30 degrees or more than 60 degrees, to enable jig 100 tofunction with various types of joints. In the embodiment shown, firstside 108 (e.g., primary portion 120) is configured to be disposed incontact with the articular surface of a glenoid such that the centrallongitudinal axis 136 a, 136 b of each of the one or more holes 116 a,116 b extends through the scapula adjacent the glenoid. In theembodiment shown, jig 100 also comprises a handle 140 extending frombody 104 (e.g., coupled to projection 144 of body 104). In theembodiment shown, handle 140 comprises a bend 144 to discourage rotationof body 104 during use and thereby improve stability and controllabilityof the jig. In other embodiments, handle 140 may include a forkedportion and/or may be U-shaped such that the handle is/can be coupled tothe body at two points.

In the embodiment shown, pin 200 has a first end 204, a second end 208,and a depth indicator 212. In this embodiment, pin 200 is configured tobe inserted into the bone adjacent the selected type of human jointsocket through one of the one or more holes 116 a, 116 b in body 104 ofthe jig to a depth indicated by depth indicator 212 such that second end208 extends a predetermined distance out of the bone. For example, inthe embodiment shown, depth indicator 212 comprises a line or other markprinted, engraved, etched, or otherwise visible at a selected point onthe pin and corresponding to a portion of second side 108 of body 104 ofthe jig. In this embodiment, when jig 100 is disposed with first side108 in contact with the articular surface of a patient's glenoid, pin200 can be inserted into one of holes 116 a, 116 b until depth indicator212 is aligned with the distal end 132 a, 132 b of the corresponding oneof projections 124 a, 124 b. In the embodiment shown, first end 204 ofpin 200 comprises a self tapping tip 216 and threaded portion 220 suchthat pin 200 can be inserted to a desired depth relative to a bone andthreaded portion 220 will substantially maintain the position of pin 200relative to the bone.

In some embodiments, the present apparatuses also comprise a reamer 300(FIG. 3E) configured to be disposed over second end 208 of the pin whenfirst end 204 of the pin is disposed in the bone, and the reamer rotatedto remove a portion of the bone to form a mating surface on the bone.For example, in the embodiment shown, reamer 300 comprises a proximalcutting end 304, a distal end 308, and shaft 312 with an elongatedpassage 316 extending from cutting end 304 toward distal end 308 andconfigured to receive second end 208 of pin 200. In this embodiment,cutting end 304 has a larger diameter relative to shaft 312 and isconfigured such that if the reamer is rotated around shaft 312, cuttingend 304 will cut away bone to contour a mating surface on the bone. Inthe embodiment shown, shaft 312 comprises a shoulder or other stop(e.g., proximal end) 320 in passage 316 configured to contact second end208 of pin 200 to limit the depth to which cutting end 304 of the reamercan cut. For example, when pin 208 is inserted into bone to a desireddepth (e.g., indicated by depth indicator 212 of pin 200 and distal end132 a of projection 124 a of jig 100), shoulder 316 is configured toensure that the mating surface of the bone is formed at a desired depthor position. In this embodiment, cutting end 304 of the reamer isconfigured to form a mating surface on the bone that corresponds to theshape of coupling side of body 14 of device 10 (e.g., substantiallyplanar).

Some embodiments of the present kits comprise: one or more devices 10and one or more of the present apparatuses (e.g., each including a jig100, at least one pin 200, and at least one reamer 300). For example,some embodiments of the present kits comprise a device 10, a jig 100,two or more pins 200, and a reamer 300. In some embodiments, thedevice(s) and apparatus(es) are sterile and/or disposed in a sealedpackage (e.g., a polymer tray with a sealing file).

Certain embodiments of the present methods will now be described withreference to FIGS. 3A-3G and 4. FIG. 3A depicts a normal glenoid portion400 of a human scapula 404. Glenoid 400 includes an anterior side 408, aposterior side 412, an articular surface 416, and a rim 420. FIG. 3Bdepicts a similar human glenoid portion 400 of a human scapula 404, butwith an anterior portion of rim 420 (and articular surface 416) brokenaway from the glenoid.

Some embodiments of the present methods repairing a human joint socket(e.g., glenoid), comprise: coupling a device (e.g., 10) with apre-formed body (e.g., 14) to a bone adjacent to a human joint socket,where the body comprises a coupling side (e.g. 18) and a concave side(e.g., 22) disposed at a non-parallel angle relative to the couplingside, and the body is coupled to the bone such that the coupling sidefaces the bone and the concave side augments the articular surface ofthe joint socket.

Some embodiments of the present methods further comprise: shaping, priorto coupling the body to the bone, the bone to correspond to the shape ofthe coupling side. For example, in some embodiments, shaping comprises:disposing a jig (e.g., 100) such that first side 108 contacts articularsurface (e.g., 416) of the joint socket, as shown in FIG. 3C. Someembodiments further comprise inserting a pin 200 into the bone (e.g.,clavicle 404) through one (116 a) of the one or more holes of the bodyof the jig to a depth indicated by depth indicator 212, as shown in FIG.3D. In some embodiments, jig 200 is then removed (from pin 200) whilepin 200 is disposed in the bone, such as, for example, by pulling thejig away from the bone over pin 200. Some embodiments further comprisedisposing reamer 300 over second end 208 of the pin and rotating thereamer to shape the bone (e.g., to shape a mating surface 424), as shownin FIG. 3E. Once the mating surface of the bone is shaped, reamer 300 isremoved from the pin 200, and pin 200 can be removed from the bone.

In embodiments using jig 100 or other jigs having two or more holes(e.g., 116 a, 116 b), the present methods can further comprise insertinga second pin 200 or inserting the same pin 200 a second time. Forexample, in some embodiments, two pins 200 are inserted through holes116 a, 116 b before removal of jig 100 from the bone, and reamer 300 isdisposed and rotated sequentially over each pin 200 while both pins aredisposed in the bone, as shown in FIG. 3E. In other embodiments, beforethe first pin or pin placement is removed, the jig is re-placed over thefirst pin such that the first side contacts the articular surface of thejoint socket, and a pin 200 is then inserted into the bone through asecond one (116 b) of the one or more holes in the body of the jig to adepth indicated by the depth indicator (212). In some embodiments, asingle pin is left in place until the jig is re-placed and then removedwhile the jig is in place and inserted into second hole 116 b. In otherembodiments, a second pin 200 is inserted into second hole 116 b whilethe first pin is still disposed in the bone and through first hole 116a, and then the first pin is removed while the second pin remainsdisposed in the bone. Once the second pin is disposed in the bone at theselected depth, the jig can then be removed from the second pin whilethe second pin is disposed in the bone, and reamer 300 disposed oversecond end 208 of the second pin and rotated to shape the bone (tofurther form the mating surface of the bone. Because the first andsecond pins are inserted into the bone at substantially parallel anglesand to substantially equal depths, the mating surface formed by thefirst and second applications of the reamer(s) are substantially alignedand form a substantially continuous mating surface on the bone. Afterthe second application of the reamer (on the second pin), the reamer andsecond pin can be removed from the bone.

Once the bone has been shaped, device 10 can be disposed adjacent to thebone with coupling side 18 facing mating surface 424, as shown in FIG.3F (e.g., without pin 200 in place). For example, jig 100 can bedisposed with first side 108 in contact with the articular surface ofthe joint to ensure appropriate placement and alignment of body 14 ofthe device. With body 14 in alignment, screws 500 (e.g., self-tapping,biocompatible screws) can be inserted into the bone through holes 30 tosecure body 14 to the bone (e.g., to the scapula, as illustrated in FIG.4). As shown in FIG. 3G, when coupled to scapula 404, concave surface 22is configured to augment the articular surface (e.g., substantiallymatch or correspond to the articular curvature) to increase theeffective articular surface area for the joint, and/or to augment thearticular rim 420 to provide a physical barrier to dislocation of theshoulder joint.

The above specification and examples provide a complete description ofthe structure and use of exemplary embodiments. Although certainembodiments have been described above with a certain degree ofparticularity, or with reference to one or more individual embodiments,those skilled in the art could make numerous alterations to thedisclosed embodiments without departing from the scope of thisinvention. As such, the various illustrative embodiments of the presentdevices, apparatuses, kits, and methods are not intended to be limitedto the particular forms disclosed. Rather, they include allmodifications and alternatives falling within the scope of the claims,and embodiments other than the one shown may include some or all of thefeatures of the depicted embodiment. For example, jig 100 and reamer 300can be configured such only one hole is included in the body of the jigto receive and position a pin 200 (e.g., in the embodiment shown, thediameter of reamer 300 is such that two pins and two applications ofreamer to the bone in two different positions will generally be requiredfor form the mating surface on the bone; but, in other embodiments, jig100 can comprise a single, central hole for positioning the pin, and thecutting end of the reamer can have a diameter that is large enough toform the mating surface with a single application of the reamer. Forexample, components may be combined as a unitary structure, and/orconnections may be substituted. Further, where appropriate, aspects ofany of the examples described above may be combined with aspects of anyof the other examples described to form further examples havingcomparable or different properties and addressing the same or differentproblems. Similarly, it will be understood that the benefits andadvantages described above may relate to one embodiment or may relate toseveral embodiments.

The claims are not intended to include, and should not be interpreted toinclude, means-plus- or step-plus-function limitations, unless such alimitation is explicitly recited in a given claim using the phrase(s)“means for” or “step for,” respectively.

1. A device comprising: a pre-formed body comprising a coupling side anda concave side disposed at a non-parallel angle relative to the couplingside, the body configured to be coupled to a bone adjacent to a selectedtype of human joint socket such that the coupling side faces the boneand the concave side augments the articular surface of the joint.
 2. Thedevice of claim 1, where the body is configured to be coupled to ascapula adjacent the glenoid such that the concave side augments ananterior portion of the glenoid rim.
 3. The device of claim 1, where thebody comprises one or more holes extending through the body withoutextending through the concave side such that the body can be coupled tothe bone by one or more screws extending through the one or more holes.4. (canceled)
 5. The device of claim 3, where the body comprises aplurality of projections extending outwardly from the coupling side andconfigured to resist movement of the body relative to the bone.
 6. Thedevice of claim 1, where the body comprises a non-biological material.7. (canceled)
 8. The device of claim 6, where the coupling side isconfigured to permit bone ingrowth into the body.
 9. (canceled)
 10. Thedevice of claim 8, where the body comprises a structural material and acoating material.
 11. The device of claim 10, where the coating materialcovers substantially all of the concave side but does not coversubstantially all of the coupling side. 12-15. (canceled)
 16. Anapparatus comprising: a jig having a body with a first side and a secondside, the first side configured to be disposed in contact with anarticular surface of a selected type of human joint socket, the bodyhaving one or more holes each extending through the first side and thesecond side such that if the first side is disposed in contact with anarticular surface of the selected type of human joint socket, thelongitudinal axis of the hole will extend into bone adjacent the jointsocket without passing through the articular surface.
 17. The apparatusof claim 16, where the first side is configured to be disposed incontact with a glenoid such that the central longitudinal axis of eachof the one or more holes extends through the scapula adjacent theglenoid.
 18. (canceled)
 19. The apparatus of claim 17, furthercomprising: a pin having a first end, a second end, and a depthindicator, the pin configured to be inserted into the bone adjacent theselected type of human joint socket through one of the one or more holesin the body of the jig to a depth indicated by the depth indicator suchthat the second end extends a predetermined distance out of the bone.20. (canceled)
 21. The apparatus of any of claim 19, further comprising:a reamer configured to be disposed over the second end of one of the pinwhen the first end of the pin is disposed in the bone, and rotated toremove a portion of the bone to form a mating surface on the bone. 22.The apparatus of claim 21, where the reamer comprises a cutting end, adistal end, and an elongated passage extending from the cutting endtoward the distal end, the passage configured to receive at least aportion of one of the one or more pins, and the reamer comprises ashoulder in the passage, the shoulder configured to contact the secondend of the pin to limit the depth to which the cutting end can cut. 23.(canceled)
 24. The apparatus of claim 21, where the shape of the matingsurface corresponds to the shape of the coupling side of the body of andevice of claim
 1. 25. (canceled)
 26. A kit comprising: a pre-formedbody comprising a coupling side and a concave side disposed at anon-parallel angle relative to the coupling side, the body configured tobe coupled to a bone adjacent to a selected type of human joint socketsuch that the coupling side faces the bone and the concave side augmentsthe articular surface of the joint; and an apparatus of claim 21; wherethe device and apparatus are sterile and are disposed in a sealedpackage. 27-28. (canceled)
 29. A method of repairing a human jointsocket, comprising: coupling a device having a pre-formed body to a boneadjacent to a human joint socket, where the body comprises a couplingside and a concave side disposed at a non-parallel angle relative to thecoupling side, and the body is coupled to the bone such that thecoupling side faces the bone and the concave side augments the articularsurface of the joint socket.
 30. (canceled)
 31. The method of claim 29,further comprising shaping, prior to coupling the body to the bone, thebone to correspond to the shape of the coupling side, where shapingcomprises: disposing a jig relative to the joint socket, the jig havinga body with a first side and a second side, the first side configured tobe disposed in contact with an articular surface of a selected type ofhuman joint socket, the body having one or more holes each extendingthrough the first side and the second side such that if the first sideis disposed in contact with an articular surface of the selected type ofhuman joint socket, the longitudinal axis of the hole will extend intobone adjacent the joint socket without passing through the articularsurface, where the jig is disposed such that the first side contacts thearticular surface of the joint socket; inserting a pin into the bonethrough one of the one or more holes of the body of the jig, the pinhaving a first end, a second end, and a depth indicator, the pinconfigured to be inserted into the bone adjacent the selected type ofhuman joint socket through one of the one or more holes in the body ofthe jig to a depth indicated by the depth indicator such that the secondend extends a predetermined distance out of the bone, where the pin isinserted to a depth indicated by the depth indicator; removing the jigwhile the pin is disposed in the bone; disposing a reamer over thesecond end of the pin and rotating the reamer to shape the bone andthereby form a mating surface on the bone; and removing the reamer andthe pin.
 32. The method of claim 31, where the one or more holes in thebody of the jig comprises two holes, and shaping further comprises:inserting a pin into the bone through a second one of the one or moreholes in the body of the jig, the pin having a first end, a second end,and a depth indicator, the pin configured to be inserted into the boneadjacent the selected type of human joint socket through one of the oneor more holes in the body of the jig to a depth indicated by the depthindicator such that the second end extends a predetermined distance outof the bone, where the pin is inserted to a depth indicated by the depthindicator; removing the jig while the second pin is disposed in thebone; disposing a reamer over the second end of the second pin androtating the reamer to shape the bone and thereby form a mating surfaceon the bone; and removing the reamer and the second pin.
 33. (canceled)34. The method of claim 29, where the pre-formed body comprises acoupling side and a concave side disposed at a non-parallel anglerelative to the coupling side, the body configured to be coupled to abone adjacent to a selected type of human joint socket such that thecoupling side faces the bone and the concave side augments the articularsurface of the joint.
 35. The method of claim 29, where the joint socketcomprises the glenoid, and where the body is coupled to the bone inwhich a portion of the glenoid rim is missing.